深圳市孕妇异位妊娠的危险因素

Risk factors for ectopic pregnancy in Shenzhen City:a case-control study

目的探讨异位妊娠的危险因素并制定相应的干预措施。方法以2005年10月至2006年9月在深圳市22家医院确诊的宫外孕患者1215例为异位妊娠组,选取正常妊娠早期人工流产238例为对照组,2组对象在生殖道感染史、人工流产史、避孕史等方面进行问卷调查,对异位妊娠进行保守治疗的155例患者和238早期终止妊娠者进行宫颈分泌物和微生物检测。结果异位妊娠组中曾患盆腔炎和输卵管炎的占35.63%(433/1215);有人工流产史占57.20%(695/1215),明显高于正常妊娠组,差异有统计学意义(χ2=21.82,P<0.01);异位妊娠组中宫颈分泌物病原微生物检出率,衣原体为6.45%(8/124)、解脲支原体为29.13%(37/127)、人型支原体为26.44%(32/121)、淋球菌为12.30%(15/122)、加特纳菌为37.50%(45/120),均高于对照组,差异有统计学意义(P<0.05)。结论异位妊娠与人工流产手术、生殖道微生物感染的慢性盆腔炎和输卵管炎有一定的相关性。

Objective To investigate the risk factors for ectopic pregnancy. Methods 1 215 women with ectopic pregnancy from 22 hospitals in Shenzhen City were used as the case group, and 238 women who had normal pregnancy but terminated early were served as the control group, questionnaire survey was conducted to collect information on vagina infection, induced abortion, and contraceptive use, etc. Cervix secretion examination and microbiological examination were performed for 155 women who adopted the expectant treatment in the case group and for all women in the control group. Results More women had pelvic inflammation and fallopian tube inflammation （35.63 % ） and induced abortion （57.26 % ） in the case group than in the control group （P 〈 0. 01 ）. Chlamydia trachomatis （ CT）, was detected in 6.45 %, ureaplasma urealyticum （UU） in 29. 13 %, mycoplasma hominis （MH） in 26.44 %, NG in 12. 30 %, and gardnrella vaginallis （GV） in 37.50 % of the 155 patients who had expectant treatment. All of these figures were higher than those in the control group （P 〈 0. 01 ）. Conclusion Ectopic pregnancy is associated with induced abortion, vagina infection, chronic pelvic inflammation, and fallopian tube inflammation.